Cognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder

Background/ObjectiveThe main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consumption).MethodThe participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task.ResultsClinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group.ConclusionsCognitive flexibility could be included treatment in the treatment of obsessive-compulsive disorder and generalized anxiety disorder.     

The role of BIS/BAS in the vulnerability for depression in adolescent girls

Reinforcement Sensitivity Theory (RST), the original (i.e. Gray, 1982) or revised (Gray & McNaughton, 2000), has yet to be used as a framework for investigating vulnerability to Major Depressive Disorder (MDD) in adolescents. The present study employed a high-risk design to examine whether aberrant BIS-FFFS/BAS activity was similarly present in both depressed girls and girls at high risk for depression.MethodsN = 85 age-matched biological daughters of mothers with differential MDD status: (a) MDD (n = 17), (b) high-risk (n = 34), and (c) healthy controls (n = 34) completed measures of the BIS/BAS, depression, and anxiety.ResultsMDD girls scored significantly higher on BIS than healthy controls but not high-risk girls, and the high-risk and control groups did not differ. No group differences were found on BAS or FFFS-Fear.ConclusionsElevated BIS was not identified as a vulnerability factor for MDD; however, it does distinguish depressed adolescents from healthy controls.     

The Spanish validation of the Short Health Anxiety Inventory: Psychometric properties and clinical utility

Background/ObjectiveThe Short Health Anxiety Inventory (SHAI) is a widely used self-report instrument to evaluate health anxiety. To assess the SHAI's factor structure, psychometric properties, and accuracy in differentiating Spanish non-clinical individuals from patients with severe health anxiety or hypochondriasis.MethodA total of 342 community participants (61.6% women; M_age = 34.60, SD = 14.91) and 31 hypochondriacal patients (51.6% women; M_age = 32.74, SD = 9.69) completed the SHAI and other self-reports assessing symptoms of hypochondriasis, depression, anxiety sensitivity, worry, and obsessive-compulsive.ResultsThe original two-factor structure was selected as the best structure, based on its parsimony and empirical support (Factor 1: Illness likelihood; Factor 2: Negative consequences of illness). Moreover, the Spanish version of the SHAI demonstrated good construct and concurrent and discriminant validity, and internal consistency. A cutoff of 40.5 (total score) accurately distinguished non-clinical individuals from patients with severe health anxiety or hypochondriasis.ConclusionsThe SHAI is an adequate screening instrument to measure health anxiety in Spanish-speaking community adults.     

Validation de l’inventaire des facteurs de résilience (IFR-40)

Bekaert, Masclet and Caron's inventory of resilience factors (IRF-40) is a French measurement scale which measures the protection factors combining to bring about resilience in adolescents. This three-dimension measurement instrument has been worked out on the basis of a literary review aiming at identifying all the protection factors reported in the research studies. An exploratory factorial analysis with oblimin rotation carried out on a sample of 299 adolescents enabled to underline the three-dimension structure (familial protection factors: personal protection factors; extra-familial protection factors) including 40 items. The study of the internal consistency reveals high coefficients for the whole scale (0.91) as well as for the different dimensions (0.77 to 0.91). The examination of the convergent validity shows significant correlations with the life satisfaction scale (r = 0.61) and the psychological well-being scale (r = 0.72). As for the temporal stability (n = 73), a measure of 0.92 was obtained. The present research aims at completing the evaluation of the psychometric properties of the IRF-40 on a sample of adolescents. With the intention of bringing to light the structure of the instrument, a confirmatory factorial analysis (CFA) was carried out on 414 adolescents (average age = 14.96). The analyses carried out approve of the three-dimension structure of the scale. The study of the divergent validity (n = 123) has brought to light a high and significant correlation (r = –0.757) between the IRF-40 and Berndt and Kaiser’ s composite depression scale as well as a significant correlation between the IRF-40 and the under scale of the MDI-C (r varies between –0.294 and –0.563). In addition, the IRF-40 enables to differentiate the adolescents exposed to a traumatism and who have depression scores to those who experience no depression. Indeed, the participants not experiencing depression obtain significantly higher scores on the IRF-40 (U = 282.5; P = 0.001) in comparison with the participants experiencing depression. What is more, it appears that the latter score lower familial protection factors (U = 443.5; P = 0.001), personal protection factors (U = 390; P = 0.001) and extra-familial factors (U = 629; P = 0.001) than those who do not experience depression. As a conclusion, the results of the present study show a very probant image of the psychometric qualities of the IRF-40 and support its use on a population of adolescents.     

Till depression do us part? Examining the prospective associations between depression and marital adjustment in older adults

IntroductionThe association between marital adjustment and depression in young couples is well established. However, little is known about the longitudinal associations between marital adjustment and depression in older adults.ObjectiveTo explore if such associations are significant in older adults and determine their direction of effects.MethodThe cross-sectional and 12-month prospective associations between diagnostic depression and marital adjustment in a representative sample of community-dwelling older adults (age ≥ 65 years, n = 847) from Quebec, Canada, were assessed through cross-lagged, multiple regression analyses.ResultsData suggest a cross-sectional association between marital adjustment and depression. As for longitudinal associations, marital adjustment predicted subsequent diagnostic depression but there was no support for the inverse path, suggesting a unidirectional relation between these variables.ConclusionWhile significant, the association between initial marital adjustment and later depression was weak. Based on our and previously reported findings, the importance of the prospective relations between marital quality and depression in older adults is discussed.     

French validation of the 7-item Game Addiction Scale for adolescents

IntroductionThe Game Addiction Scale (GAS: Lemmens, Valkenburg, & Peter, 2008, 2009) is a short instrument (7-item) for evaluating video game playing by adolescents.ObjectiveThe aim of the current research was to investigate the psychometric properties of a French version of the 7-item Game Addiction Scale for adolescents.MethodTwo studies were conducted with two samples of French adolescents between the ages of 10 and 18 (study 1: n = 159; study 2: n = 306). First, we examined the factor structure and internal consistency. Second, we added a concurrent validity analysis with estimation of the daily time spent playing video games and an assessment of depression and anxiety.ResultsIn both studies, the factor analysis revealed a one-factor structure that had good psychometric properties and fit the data well. The analysis also confirmed good internal consistency of the scale. Correlation analysis in the second study showed that the GAS score had significant positive relationships with the time spent playing video games, depression, anxiety, and the fact of being a boy, thereby supporting the concurrent validity of the scale.ConclusionThis French version of the GAS seems to be a reliable tool for identifying and assessing problematic use of video games.     

Rumination and depression in Chinese university students: The mediating role of overgeneral autobiographical memory

ObjectiveIn this study, we examined the mediator effects of overgeneral autobiographical memory (OGM) on the relationship between rumination and depression in 323 Chinese university students.Method323 undergraduates completed the questionnaires measuring OGM (Autobiographical Memory Test), rumination (Ruminative Response Scale) and depression (Center for Epidemiologic Studies Depression Scale).ResultsResults using structural equation modeling showed that OGM partially-mediated the relationship between rumination and depression (χ² = 88.61, p < .01; RMSEA = .051; SRMR = .040; and CFI = .91). Bootstrap methods were used to assess the magnitude of the indirect effects. The results of the bootstrap estimation procedure and subsequent analyses indicated that the indirect effects of OGM on the relationship between rumination and depressive symptoms were significant.ConclusionThe results indicated that rumination and depression were partially mediated by OGM.     

A speech and psychological profile of treatment-seeking adolescents who stutter

PurposeThe purpose of this study was to evaluate the relationship between stuttering severity, psychological functioning, and overall impact of stuttering, in a large sample of adolescents who stutter.MethodParticipants were 102 adolescents (11–17 years) seeking speech treatment for stuttering, including 86 boys and 16 girls, classified into younger (11–14 years, n = 57) and older (15–17 years, n = 45) adolescents. Linear regression models were used to evaluate the relationship between speech and psychological variables and overall impact of stuttering.ResultsThe impact of stuttering during adolescence is influenced by a complex interplay of speech and psychological variables. Anxiety and depression scores fell within normal limits. However, higher self-reported stuttering severity predicted higher anxiety and internalizing problems. Boys reported externalizing problems—aggression, rule-breaking—in the clinical range, and girls reported total problems in the borderline-clinical range. Overall, higher scores on measures of anxiety, stuttering severity, and speech dissatisfaction predicted a more negative overall impact of stuttering.ConclusionTo our knowledge, this is the largest cohort study of adolescents who stutter. Higher stuttering severity, speech dissatisfaction, and anxiety predicted a more negative overall impact of stuttering, indicating the importance of carefully managing the speech and psychological needs of adolescents who stutter. Further research is needed to understand the relationship between stuttering and externalizing problems for adolescent boys who stutter.     

Les couples mis à l’épreuve du confinement de la crise Covid

ObjectivesThe COVID-19 pandemic resulted in strict containment. The isolation and anxietyinducing nature of the situation had an impact on the mental health of individuals. Our study examines the intimacy of individuals confined with or without their partners during this period and explores the risk factors and resources available to them.MethodologyWe distributed an online questionnaire during the first lockdown (April 2020). In total, 1985 adults (80.3% female; M = 34.27, SD = 14.96) participated in the study. Several validated scales assessed life context, mental health, substance use (alcohol and cannabis), intolerance of uncertainty and intimacy in the couple. Participants described their experiences through open-ended questions.ResultsOur results indicate that couples who lived in separate households during confinement (n = 453 or 22.8% of our sample) were more depressed, more anxious and more intolerant of uncertainty. Through a thematic analysis, we found that couples who were confined together were more likely to report an improvement in the quality of their emotional and sexual life than couples separated by confinement. However, restriction of available space, reorganisation of work and leisure activities and relationships with children emerged as potential stressors.ConclusionThe intimate partner can be a form of support for stress during containment and supports resilience in a pandemic crisis.     

Motivational characteristics of obese adolescents toward physical activity: Contribution of self-determination theory

IntroductionRegular physical activity (PA) practice represents a key component of obesity treatment.ObjectiveBased on self-determination theory (SDT), this cross-sectional study aimed to explore the motivational characteristics associated with PA practice among obese adolescents.MethodOne hundred and five overweight or obese adolescents (mean age = 15 years old, SD = 2.69) were questioned about their level of PA, motivational regulations toward PA and level of satisfaction of basic psychological needs.ResultsData revealed that satisfaction of autonomy and relatedness needs is positively associated with autonomous forms of motivation (e.g., for integrated regulation β = .44; and 0.35, respectively, p < .01). Otherwise, non-satisfaction of the needs of autonomy and competence is associated with the most controlled forms of motivation (e.g., for external regulation β = −.27, p < .01; and −.18, p < .05, respectively). In turn, a high level of identified regulation, a low level of external regulation and a high level of satisfaction of the need for competence are associated with weekly PA (β = .28; −.19 and .24, respectively, p < .05).ConclusionSDT appears as an interesting theoretical framework to explore motivational antecedents of PA among obese adolescents.     

Intelligence and emotional disorders: Is the worrying and ruminating mind a more intelligent mind?

Previous research has shown that anxiety and depression symptoms are negatively associated with measures of intelligence. However, this research has often not taken state distress and test anxiety into account, and recent findings indicate possible positive relationships between generalized anxiety disorder (GAD), worry, and intelligence. The present study examined the relationships between GAD, depression, and social anxiety symptoms, as well as their underlying cognitive processes of worry, rumination, and post-event processing, with verbal and non-verbal intelligence in an undergraduate sample (N = 126). While the results indicate that verbal intelligence has positive relationships with GAD and depression symptoms when test anxiety and state negative affect were taken into account, these relationships became non-significant when overlapping variance was controlled for. However, verbal intelligence was a unique positive predictor of worry and rumination severity. Non-verbal intelligence was a unique negative predictor of post-event processing. The possible connections between intelligence and the cognitive processes that underlie emotional disorders are discussed.     

Personal values and unsanctioned aggression inherent in contact sports: The role of self-regulatory mechanisms,aggressiveness, and demographic variables

IntroductionTo date, research-examining factors related to the sociocognitive self-regulatory mechanisms governing unsanctioned aggression have received scant attention in applied sport psychology.ObjectiveA mediating model as influenced by various demographic variables was applied to explore the relationships between athletes’ personal values and their unsanctioned aggression directly and indirectly through the mediating role of resistive self-regulatory efficacy, moral disengagement, and aggressiveness.MethodA sample of 301 French competitors of different age (young: n = 200 and adult: n = 101), gender (male: n = 172 and female: n = 129), type of sport (high: n = 131 and low contact: n = 170), level of competition (beginner: n = 115, intermediate: n = 110, and advanced: n = 76), and length of practice (brief: n = 109, intermediate: n = 49, and extensive: n = 143) completed a questionnaire assessing the aforementioned variables.ResultsStructural equation modelling demonstrates that self-transcendence and self-enhancement values have only indirect negative and positive effects, respectively, on unsanctioned aggression through the full mediating effect of the mediators. Also, age, gender, and type of sport were predictive only of some personal values and mediators.ConclusionThese findings offer evidence that resistive self-regulatory efficacy, moral disengagement, and aggressiveness are mediators that fully govern the impact of athletes’ personal values and certain demographic variables on their unsanctioned aggression. Several limitations, implications and suggestions for further research are discussed.     

Exposure-Based Family Therapy (FBT-E): An Open Case Series of a New Treatment for Anorexia Nervosa

The overlap between anorexia nervosa (AN) and anxiety disorders has led to the development of anxiety-based etiological models of AN and anxiety-based interventions for AN, including exposure treatment. Family-based treatment (FBT) is an efficacious intervention for adolescents with AN; however, it has recently been proposed that FBT accomplishes parent-facilitated exposure and habituation to food and related triggers in the individual's natural environment. FBT was recently altered to include an explicit exposure component that targets the broad construct of anxiety, including fear, worry, and disgust. This case series examines the application of FBT with an exposure component (FBT-E) to a group of adolescents meeting diagnostic criteria for AN (n = 4) and eating disorder not otherwise specified–restricting type (SAN, n = 6). Ten outpatients (ages 12–17, mean age: 15.28) participated in a course of FBT-E. Session-by-session weight was examined, along with BMI at pre- and posttreatment and responses to self-report measures of eating disorder symptoms (Eating Disorder Examination Questionnaire; EDE-Q), depression and anxiety. Parent reports of their adolescents' anxiety were also collected. The results of this study provide preliminary evidence that FBT-E may effectively target disordered eating and anxiety symptoms and may be a viable alternative to traditional FBT. Implications and future directions are discussed.     

Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.     

Worry and the anxiety disorders: A meta-analytic synthesis of specificity to GAD

Although worry is central to the diagnosis of generalized anxiety disorder (GAD), it is also commonly observed in other anxiety disorders. In this meta-analytic review, we empirically evaluated the extent to which worry is specific to GAD relative to patients with other anxiety disorders, those with other psychiatric disorders, and nonpsychiatric controls. A total of 47 published studies (N = 8,410) were included in the analysis. The results yielded a large effect size indicating greater severity/frequency of worry, meta-worry, and domains of worry among anxiety disorder patients v. nonpsychiatric controls (d = 1.64). In contrast to the many differences emerging from comparisons between anxiety disordered patients and nonpsychiatric controls, when anxiety disordered patients were compared to people with other psychiatric disorders they differed only on severity/frequency and not on meta-worry or domains of worry. A large effect size indicating greater severity/frequency of worry, meta-worry, and domains of worry among patients with GAD v. nonpsychiatric controls was also found (d = 2.05). However, differences between GAD and those with other psychiatric disorders also emerged for severity/frequency of worry. GAD was associated with greater worry difficulties than other anxiety disorders, which generally did not differ from those with other psychiatric disorders and each other. The implications of these findings for conceptualizing worry in GAD and other anxiety disorders, and the potentially moderating effects of age and gender are discussed.     

Mechanisms underlying the self-talk–performance relationship: The effects of motivational self-talk on self-confidence and anxiety

ObjectivesThe present study examined the effects of motivational self-talk on self-confidence, anxiety, and task performance in young athletes.MethodsParticipants were 72 tennis players. The experiment was conducted in five sessions: baseline assessment, three training sessions, and final assessment. After the baseline assessment participants were divided and assigned randomly into experimental and control groups. The two groups followed the same training program with the experimental group practicing the use of self-talk. In the last session, the final assessment took place. A forehand drive test was used to evaluate task performance, and the Competitive Anxiety Inventory-2R was used to assess self-confidence and anxiety.ResultsA two-way mixed model MANOVA revealed that task performance improved for the experimental group (p < .01) and remained stable for the control group; self-confidence increased (p < .01) and cognitive anxiety decreased (p < .05) for the experimental group, whereas no changes were observed for the control group. Correlation analysis revealed that changes in task performance were moderately related to changes in self-confidence (p < .05).ConclusionsThe results of the study showed that self-talk can enhance self-confidence and reduce cognitive anxiety. Furthermore, it is suggested that increases in self-confidence can be regarded as a viable function explaining the facilitating effects of self-talk on performance.     

Axis I anxiety and mental health disorders among stuttering adolescents

PurposeThe purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents.MethodParticipants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12–14 years; n = 20) and older adolescents (15–17 years; n = 17).ResultsThirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate–severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15–17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12–14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status.DiscussionThese results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations.Educational Objectives: The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment.     

A Test of the Habit-Goal Framework of Depressive Rumination and Its Relevance to Cognitive Reactivity

The aim of the present study was to test predictions derived from the habit-goal framework of depressive rumination and investigate its relevance to cognitive reactivity—another well-known vulnerability factor to depression. Formerly depressed (FD; n = 20) and never depressed (ND; n = 22) participants completed self-report measures of rumination, cognitive reactivity, and habitual characteristics of rumination (e.g., lack of awareness, control, intent). A standard mood-induction task was also used to measure cognitive reactivity and an outcome-devaluation task to measure general habit vs. goal-directed behavior control. Habitual characteristics of ruminative thoughts were greater in the FD group and were related to depressive brooding and cognitive reactivity, but not reflective pondering. Reliance on habit on the outcome-devaluation task was strongly correlated with number of depression episodes, although group differences were not observed in general habit vs. goal-directed control. Habitual characteristics of rumination (e.g., greater automaticity) may explain reactivity and persistence of negative thoughts in depression. Habitual behavior control may contribute to inflexible responding and vulnerability for depression episodes.     

Cognitive Mediation of Symptom Change in Exposure and Response Prevention for Obsessive-Compulsive Disorder

This study examined cognitive mediators of symptom change during exposure and response prevention (EX/RP) for obsessive–compulsive disorder (OCD). Based on cognitive models of OCD, obsessive beliefs were hypothesized as a mediator of symptom change. Participants were 70 patients with primary OCD receiving EX/RP either as part of a randomized controlled trial (n = 38) or in open treatment following nonresponse to risperidone or placebo in the same trial (n = 32). Blinded evaluations of OCD severity and self-report assessments of three domains of obsessive beliefs (i.e., responsibility/threat of harm, importance/control of thoughts, and perfectionism/intolerance of uncertainty) were administered during acute (Weeks 0, 4 and 8) and maintenance treatment (Weeks 12 and 24). Study hypotheses were examined using cross-lagged multilevel modeling. Contrary to predictions, the obsessive beliefs domains investigated did not mediate subsequent OCD symptom reduction. In addition, OCD symptoms did not significantly mediate subsequent change in obsessive beliefs. The present study did not find evidence of cognitive mediation during EX/RP for OCD, highlighting the need to investigate other plausible mediators of symptom improvement.     

Distributed attentional deficits in chronic methamphetamine abusers: Evidence from the Attentional Network Task (ANT)

ObjectiveThe goal of the present study was to examine distributed attentional functions in long-term but currently abstinent methamphetamine (MA) abusers using a task that measures attentional alertness, orienting, and conflict resolution.MethodsThirty currently abstinent MA abusers (1 month–5 years) and 22 healthy non-substance using adults were administered a multimodal version of the Attentional Network Task (ANT-I). In this task subjects identified the direction of a centrally presented arrow using a key press. Analyses examined the interaction between alerting tones, location cueing and congruency between the target arrows and flanking distractor stimuli.ResultsAll participants were faster when an auditory tone preceded the trial onset (p < 0.001), on trials in which a valid cue preceded the location of the target arrow (p < 0.001), and on congruent trials (i.e., when all display arrows faced in the same direction) (p < 0.001). Of primary interest was the finding that MA abusers were more influenced by the conflict between the peripheral arrows and the central target arrow (p = 0.009). There were also correlations between length of drug sobriety and executive function as well as between drug-induced psychiatric symptoms and alertness.ConclusionsThese results suggest that chronic MA abusers display cognitive deficits that may reflect a specific vulnerability to distraction on a task of executive function. These findings are consistent with other studies that have reported deficits in anterior attentional systems and top-down cognitive control.